Provider Demographics
NPI:1568680544
Name:WEST, ALLAN LEE (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:LEE
Last Name:WEST
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83606-0041
Mailing Address - Country:US
Mailing Address - Phone:208-454-8107
Mailing Address - Fax:
Practice Address - Street 1:215 S 11TH AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-3800
Practice Address - Country:US
Practice Address - Phone:208-454-8107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMFT-2848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist